This K23 application requests support for education, training and an investigation of mechanisms that influence adoption of new practices in substance abuse treatment. The research plan hypothesizes that counselor and organizational dimensions directly impact implementation of evidence-based treatment strategies. Three unified studies use a mixed-methods (quantitative and qualitative) approach to explore counselor and organizational characteristics influences on the implementation of empirically supported strategies within community based programs.
Specific Aim 1 : Use qualitative interviews and focus groups to identify and describe core counselor attributes and organizational dimensions that influence implementation of evidence-based practices in substance abuse treatment. Interviews will be completed with agency directors, clinical supervisors, and financial administrators (n=36) and focus groups will be held with counselors (n = 72) from 12 outpatient programs participating in the NIDA Clinical Trials Network and the National Treatment Center Study (NTCS) in Oregon and California.
Specific Aim 2 : Systematic observation and chart review will document and describe fidelity efforts and overall adoption of evidence-based practices in community-based treatment programs. During site visits, fidelity and adoption of specific practices will be assessed through documentation and summary of training hours, supervision, use of practical fidelity tools, performance feedback, availability of manuals, and use of rating scales. Findings from this aim will enhance identification of core components and full practice implementation by providing more detailed evidence of specific mechanism within core components Specific Aim 3: Conduct secondary analysis of the NTCS longitudinal data to identify core attributes (counselor and organizational) that predict acceptance of evidence-based practice. Counselor (n = 362) data from 69 publicly funded outpatient treatment programs will be analyzed using multilevel mixed model regression analyses. Results will document and operationalize attributes that influence implementation and illuminate common factors across programs. This career development application enhances the investigator's skills, explores variables that facilitate or inhibit the use of science-based therapies for alcohol and drug disorders, and ultimately promotes more effective and efficient treatment services. ? ? ?
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